How does it impact brain and vascular health?

• A biological age gap is the difference between a person’s chronological age based on their birthday, and their body’s biological age.
• Past studies show that having a large biological age gap can increase your risk for a number of health issues, including heart disease and dementia.
• Your biological age gap can be improved by making healthy lifestyle choices.
• A new study found that improving your biological age gap may also lower your stroke risk and provide better brain health.

A biological age gap is the difference between a person’s chronological age based on their birthday, and their body’s biological age.

As this is an abstract presented at a meeting, the results of the study have yet to be published in a peer-reviewed scientific journal.

For this study, researchers analyzed health data for more than 258,000 people and measured 18 health-related biomarkers, including cholesterol levels and red blood cell volume, along with brain scans, to determine each participant’s biological age. They also recalculated biological age for roughly 6,000 participants during a follow-up visit.

“Chronological age is the number of years you’ve been alive,” Cyprien Rivier, MD, MSc, instructor in the Department of Neurology at Yale School of Medicine and inaugural Ralph L. Sacco Scholar in Brain Health, and lead author of this study, explained to Medical News Today.

“Biological age reflects how old your body actually functions. We can estimate biological age from routine blood tests most people already get, like cholesterol and blood cell counts.”

“The gap is simply the difference between the two. Some people’s bodies are aging faster than their calendar age suggests; meaning their gap is positive, while others are aging more slowly.”

Rivier said they decided to look at how a person’s biological age gap might impact their brain health and stroke risk because faster biological aging has been linked to poor health outcomes broadly, but its relationship to the brain specifically was under-explored.

“And the more interesting question to us was not just whether the gap matters (we already knew it did), but whether changes in that gap over time predict what happens to the brain years later,” he added.

“That felt like a more actionable question, because it implies biological aging might be something we can modify to improve our brain health and reduce the risk of cognitive decline, stroke, and dementia.”

At the start of the study, participants had an average chronological age of 56 and average biological age of 54. Six years later, study participants had an average chronological age of 62 and average biological age of 58.

Researchers found that participants who improved their biological age gap between the start of the study and the repeat assessment had a 23% lower risk of having a stroke during the follow-up period.

“The important point here is that we’re looking at change over time, not just a snapshot,” Rivier said.

“It is not simply that biologically younger people have fewer strokes, it is that people who moved in the right direction over time (improved their biological age gap) had meaningfully better outcomes a decade later.”

Additionally, scientists found participants with an improved biological age gap also experienced a lower volume of white matter hyperintensities — a sign of white matter tissue damage, which can lead to memory problems and cognitive decline.

Overall, the total volume of damage was 13% lower for each standard deviation in improvement for these participants.

“White matter hyperintensities are spots visible on brain MRI that reflect damage to the brain’s white matter,” Rivier explained.

“They accumulate silently over years and are strongly linked to stroke and cognitive decline. Finding that people who improved their biological age gap had 13% less of this damage per standard deviation of improvement tells us the benefit isn’t limited to stroke risk, it also extends to the structural integrity of the brain itself.”

“That is important because this kind of tissue-level damage often precedes symptoms by years. Detecting a difference at the imaging level suggests we may be capturing something early and meaningful.”

MNT had the opportunity to speak with John Hanna, MD, vascular neurologist at the Comprehensive Stroke Center at Atlantic Health Overlook Medical Center in New Jersey, about this study, who commented that the findings are plausible and consistent with likely what we already know, that individuals with better cardiometabolic health have lower stroke risk.

“However, this is observational data,” Hanna continued. “[The] biological age metric is largely built from vascular and inflammatory markers, so the study could be capturing improved vascular risk control rather than proving that modifying biological aging itself reduces stroke incidence.”

“Stroke [has] currently moved up to be the fourth cause of death in the U.S. and a leading cause of disability,” he explained. “Search for better tools to quantify physiological aging can assist in personalized prevention strategies and risk reduction. This will allow the clinician to intervene sooner and with more precise targeted strategies.”

“Next steps [for this research] would include randomized clinical trials testing targeted interventions that reduce the biological/chronological age gap to determine whether this leads to a true causal reduction in stroke risk and markers of small vessel disease on MRI,” Hanna added.

MNT also spoke with Dung Trinh, MD, internist for MemorialCare Medical Group and chief medical officer of Healthy Brain Clinic in Irvine, CA, about this study, who said he found the results to be both encouraging and motivating.

“Encouraging because we saw a consistent link between improving a person’s biological age gap over time and better brain-related outcomes — like lower stroke risk and more favorable brain imaging markers,” Trinh detailed.

“Motivating because it reinforces how closely brain health is tied to whole-body health, and it gives us a measurable signal we can study more deeply. At the same time, it is important to emphasize this is an association — this study does not prove that changing biological age directly prevents stroke.”

For readers who may want to work on lowering the gap between their chronological and biological ages to potentially help preserve brain health and lower their stroke risk, Trinh said many of the factors that influence stroke risk and overall cardiometabolic health are also the kinds of factors that are often linked to healthier aging markers.

“The key message is what is good for the heart and blood vessels is generally good for the brain,” Trinh added.